A new study has revealed that gay men report having a higher rate of cancer diagnosis and survival than heterosexual and bisexual men. That study, just published in the journal Cancer, seems to have raised more question than it has answered however.
To help clarify the results, Healthy Living News discussed the study with its lead researcher, Ulrike Boehmer, PhD, of Boston University. Because there is limited data on gay, lesbian and bisexual cancer rates, Dr. Boehmer and her team wanted to determine what those rates might be.
They collected data from the 2001, 2003, and 2005 California Health Interview Survey (CHIS), the largest of its kind in the U.S. They then compared the survey results of gay, lesbian and bisexual men and women with those given by heterosexual men and women.
The results showed no significant overall cancer rate differences between lesbian, bisexual and heterosexual women. Gay men, however, self-reported a 1.9 higher rate of having had and survived cancer than heterosexual men. Interestingly, bisexual men reported lower rates of cancer diagnosis and survival than either their gay or straight counterparts.
”We can only speculate why gay men have a higher cancer prevalence than heterosexual men,” Dr. Boehmer explained. “It is conceivable that HIV status may have contributed to the higher cancer prevalence in gay men.” Dr. Boehmer added, “There are AIDS-related cancers, but in addition, there are also non-AIDS defining cancers. These cancers may have contributed to our finding of a higher prevalence. We have not been able to test this in our study, because we did not have data on HIV status.”
Significantly, the study also did not examine other possible contributing lifestyle and cancer risk factors such as sexually transmitted diseases, smoking, substance abuse, sun exposure, or family cancer history. These may have helped explain the differences in cancer rates and survival. Especially as gay men, as well as lesbians, have higher rates of some of these lifestyle factors, Boehmer noted.
The study also showed that the gay men reported having developed and survived more of some types of cancer than others. For example, the gay men who were surveyed reported a higher rate of developing and surviving anal cancer than heterosexual men, yet lower rates of prostate and colon cancer.
Dr. Boehmer believes more data is needed to explain the differences in cancer rates and survival and see if there is any direct or indirect connection with sexual orientation. That research could answer the questions of whether more gay men are getting cancer overall, or are they just surviving cancer longer than heterosexual men, or perhaps its both.
”It is important for future studies to determine if that more gay men reporting a cancer history stems from proportionally more gay men receiving cancer diagnoses, or from more gay men surviving a diagnosis, compared to heterosexual men,” said Dr. Boehmer.
Until then, Dr. Boehmer stressed that the survey was of just one time period and one place. ”What we have is a one-time snapshot of lesbian, gay, and bisexual individuals living with cancer, compared to heterosexual individuals in California. This should not be misunderstood as any indication of cancer risk or cancer incidence,”
Dr. Boehmer cautioned. In addition to the higher rates of cancer, the gay men also reported that their cancer was diagnosed at an earlier age. For gay men it averaged age 41, for heterosexual men it was 51. But the gay men, who are members of a demographic group that often have health issues, also visited a doctor more often. That could help explain the earlier age of diagnosis and the higher rates of cancer survival. Early diagnosis can significantly improve cancer survival.
Dr. Boehmer stressed that the question about sexual orientation and cancer are also a women’s issue. Are lesbian and bisexual women more likely than heterosexual women to get cancer overall? Although the CHIS data didn’t point in that direction, future studies may disagree.
The larger significance of the study is it begins in helping determine whether sexual orientation is a factor in cancer incidence and survival. Especially now that more health registries and surveys like CHIS are beginning to collect data on sexual orientation and health.
For many at-risk communities, the rates of cancer incidence and survival are already being used to take action and erode cancer health disparities. Studies such as Dr. Boehmer’s could one day help determine if, what, and where cancer prevention and survival programs should be mobilized for the gay, lesbian and bisexual communities.
“Sexual orientation is widely recognized as one health disparity factor but we have been hindered in showing sexual orientation disparities within the context of cancer.” Dr. Boehmer noted. “Our estimates of cancer in populations deprived of health monitoring are hopefully only the beginning.”